How Far We Have Not Come: An Empirical Comparison of Federal and State Mental Health Legislation

This Note provides an overview of significant changes in mental health law from the nineteenth century onward and analyzes whether federal or state legal interventions create any discernible change in subjective mental health using difference-in-differences analysis. Further, this Note examines trends in the use of community-based mental health services. A quasi-experimental comparison of self-reported mental health before and after passage of the federal Mental Health Parity and Addiction Equality Act and the settlement of the Arnold v. Sarn lawsuit in Arizona shows that while state law had a marginally larger effect than federal law, neither system is particularly effective in creating change for individuals with mental illness. This Note offers an explanation for the shortcomings of current laws and provides empirically based suggestions for addressing them.